Does Screening for Opioid Use Disorder in Primary Care Increase the Percentage of Patients With a New Diagnosis?
Authors: John C. Fortney, Anna D. Ratzliff, Brittany E. Blanchard, Morgan Johnson, Lori Ferro, Elizabeth J. Austin, Emily C. Williams, Mark H. Duncan, Joseph O. Merrill, Jennifer Thomas, Brandon Kitay, Michael Schoenbaum, Patrick J. Heagerty, Andrew J. Saxon
Journal: Annals of Internal Medicine (2023)

LettersOctober 2023Does Screening for Opioid Use Disorder in Primary Care Increase the Percentage of Patients With a New Diagnosis?John C. Fortney, PhD*, Anna D. Ratzliff, MD, PhD*, Brittany E. Blanchard, PhD, Morgan Johnson, MS, Lori Ferro, MHA, Elizabeth J. Austin, PhD, Emily C. Williams, PhD, Mark H. Duncan, MD, Joseph O. Merrill, MD, Jennifer Thomas, MD, Brandon Kitay, MD, Michael Schoenbaum, PhD, Patrick J. Heagerty, PhD, Andrew J. Saxon, MDJohn C. Fortney, PhD*Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington; Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington; and Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound, Seattle, WashingtonSearch for more papers by this author, Anna D. Ratzliff, MD, PhD*Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, and Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington, Seattle, WashingtonSearch for more papers by this author, Brittany E. Blanchard, PhDDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WashingtonSearch for more papers by this author, Morgan Johnson, MSDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WashingtonSearch for more papers by this author, Lori Ferro, MHADepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WashingtonSearch for more papers by this author, Elizabeth J. Austin, PhDDepartment of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WashingtonSearch for more papers by this author, Emily C. Williams, PhDDepartment of Health Systems and Population Health, School of Public Health, University of Washington, and Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound, Seattle, WashingtonSearch for more papers by this author, Mark H. Duncan, MDDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WashingtonSearch for more papers by this author, Joseph O. Merrill, MDDepartment of Medicine, School of Medicine, University of Washington, Seattle, WashingtonSearch for more papers by this author, Jennifer Thomas, MDMorris Hospital and Healthcare Centers, Morris, IllinoisSearch for more papers by this author, Brandon Kitay, MDDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GeorgiaSearch for more papers by this author, Michael Schoenbaum, PhDNational Institute of Mental Health, Bethesda, MarylandSearch for more papers by this author, Patrick J. Heagerty, PhDDepartment of Biostatistics, School of Public Health, University of Washington, Seattle, WashingtonSearch for more papers by this author, Andrew J. Saxon, MDDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, and Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound, Seattle, WashingtonSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-1369 Annals Author Insight Video - Jennifer Thomas, MD In this video, Jennifer Thomas, MD, offers additional insight into the article, "Does Screening for Opioid Use Disorder in Primary Care Increase the Percentage of Patients With a New Diagnosis?" (Duration 3:42) SectionsSupplemental MaterialAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Integrating care for common mental health disorders into primary care through screening and treatment has proved to be highly effective and is now a widespread practice. Primary care may also be an ideal setting to offer treatment for opioid use disorder (OUD), as primary care providers make up the bulk of buprenorphine prescribers (1). However, substance use disorders often go unrecognized in primary care. Screening may be an effective approach to increase identification of OUD, as it is for depression, anxiety, and alcohol use disorder (2, 3). The U.S. Preventive Services Task Force recommends screening for substance use in ...References1. Stein BD, Saloner B, Schuler MS, et al. Concentration of patient care among buprenorphine-prescribing clinicians in the US. JAMA. 2021;325:2206-2208. [PMID: 34061152] doi:10.1001/jama.2021.4469 CrossrefMedlineGoogle Scholar2. Gilbody S, Sheldon T, House A. Screening and case-finding instruments for depression: a meta-analysis. CMAJ. 2008;178:997-1003. [PMID: 18390942] doi:10.1503/cmaj.070281 CrossrefMedlineGoogle Scholar3. Lee AK, Bobb JF, Richards JE, et al. Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial. JAMA Intern Med. 2023;183:319-328. [PMID: 36848119] doi:10.1001/jamainternmed.2022.7083 CrossrefMedlineGoogle Scholar4. Austin EJ, Briggs ES, Ferro L, et al. Integrating routine screening for opioid use disorder into primary care settings: experiences from a national cohort of clinics. J Gen Intern Med. 2023;38:332-340. [PMID: 35614169] doi:10.1007/s11606-022-07675-2 CrossrefMedlineGoogle Scholar5. Oga EA, Mark K, Peters EN, et al. Validation of the NIDA-modified ASSIST as a screening tool for prenatal drug use in an urban setting in the United States. J Addict Med. 2020;14:423-430. [PMID: 32032210] doi:10.1097/ADM.0000000000000614 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: John C. Fortney, PhD; Anna D. Ratzliff, MD, PhD; Brittany E. Blanchard, PhD; Morgan Johnson, MS; Lori Ferro, MHA; Elizabeth J. Austin, PhD; Emily C. Williams, PhD; Mark H. Duncan, MD; Joseph O. Merrill, MD; Jennifer Thomas, MD; Brandon Kitay, MD; Michael Schoenbaum, PhD; Patrick J. Heagerty, PhD; Andrew J. Saxon, MDAffiliations: Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington; Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington; and Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound, Seattle, WashingtonDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, and Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington, Seattle, WashingtonDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WashingtonDepartment of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WashingtonDepartment of Health Systems and Population Health, School of Public Health, University of Washington, and Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound, Seattle, WashingtonDepartment of Medicine, School of Medicine, University of Washington, Seattle, WashingtonMorris Hospital and Healthcare Centers, Morris, IllinoisDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GeorgiaNational Institute of Mental Health, Bethesda, MarylandDepartment of Biostatistics, School of Public Health, University of Washington, Seattle, WashingtonDepartment of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, and Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound, Seattle, WashingtonDisclaimer: The statements presented in this article are solely the responsibility of the authors and do not necessarily represent the views of the National Institutes of Health (NIH).Financial Support: This work was supported by the National Institute of Mental Health (NIH/NIMH; grant UF1MH121942). Dr. Blanchard was supported by University of Washington’s Institute of Translational Health Sciences KL2 Program through the National Center for Advancing Translational Sciences of the NIH (KL2TR002317) and the National Institute on Drug Abuse Loan Repayment Program (L30DA056956).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-1369.Data Sharing Statement: The authors have indicated they will not be sharing data. The data represent counts of patients diagnosed with OUD from 20 clinics. Data from individual patients collected as part of the larger clinical trial will be made available in a public use data set.Corresponding Author: John C. Fortney, PhD, Department of Psychiatry, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA 98195; e-mail, fortneyj@uw.edu.This article was published at Annals.org on 17 October 2023.* Drs. Fortney and Ratzliff served as co–primary authors of the manuscript. PreviousarticleNextarticle Advertisement Annals Author Insight Video - Jennifer Thomas, MD In this video, Jennifer Thomas, MD, offers additional insight into the article, "Does Screening for Opioid Use Disorder in Primary Care Increase the Percentage of Patients With a New Diagnosis?" (Duration 3:42) FiguresReferencesRelatedDetails Metrics October 2023Volume 176, Issue 10 Page: 1431-1433 Keywords Drug screening Health screening Opioid use disorder Opioids Psychiatry and mental health Psychometrics ePublished: 17 October 2023 Issue Published: October 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...